The efficacy and drug interactions of Regeneron Cemiplimab in the United States
Cemiplimab is a PD-1 inhibitor that activates T cell anti-tumor immunity by blocking the PD-1/PD-L1 pathway. Its drug interactions mainly involve immunomodulators and drugs that affect metabolic enzymes, and special attention should be paid to the risks of combination therapy.
1. Effect of action
(1) Antitumor mechanism: selectively binds to PD-1 receptors, relieves tumor cells' immune suppression of T cells, and restores the immune system's recognition and killing function against cancer cells.
(2) Indications: Approved for advanced skin squamous cell carcinoma, non-small cell lung cancer and other PD-L1 high expression tumors, with an objective response rate of about 30-50%.
(3) Effective time: The first efficacy evaluation for most patients is 8-12 weeks after medication, and the duration of remission can reach more than 2 years.
2 drug interactions
(1) Immunosuppressants: Corticosteroids and other factors may weaken the efficacy of simipilimumab, and treatment needs should be balanced to avoid long-term high-dose combination therapy.
(2) CYP3A4 influencing substances: Grapefruit (inhibitor) or St. John's wort (inducer) may alter blood drug concentrations and should be avoided from ingestion.
(3) Other immune checkpoint inhibitors: Combination use of PD-1/CTLA-4 inhibitors may increase the incidence of immune related adverse reactions by 3-5 times.
(4) Live vaccine: Vaccination during treatment may cause vaccine related infections, with an interval of ≥ 3 months.
3 Monitoring requirements
(1) When using immunomodulators in combination, liver function, thyroid function, and immune related adverse reactions such as diarrhea should be monitored every 2 weeks.
(2) When combined with CYP3A4 substrates (such as warfarin), it is necessary to strengthen monitoring of coagulation function and adjust the dosage if necessary.
(3) When a grade ≥ 2 adverse reaction occurs, the medication should be suspended and reduced in dosage should be considered after recovery.
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